目的：探讨血清肿瘤相关物质（tumor associated material，TAM）和角化素蛋白片段19（Cyfra21-1）检测在食管癌诊断和化疗疗效判定中的价值。方法选取2012年9月～2013年9月92例初诊食管癌和术后复发食管癌病人为研究对象，以同时期健康体检者为对照组，分别测定其血清 TAM 和 Cyfra21-1水平，计算检测指标的灵敏度和特异度。另外，收集2012年9月～2014年4月化疗前血清 TAM 和 Cyfra21-1均升高食管癌患者60例，化疗2周期后再次检测 TAM 和Cyfra21-1水平，以有效患者指标下降，进展患者指标上升计算判定符合率。结果92例初诊和术后复发食管癌患者，血清 TAM 升高66例，Cyfra21-1升高47例，灵敏度分别为71.7％和51.1％（χ2＝8.279，P ＝0.004）。对照组50例，TAM 阴性47例，Cyfra21-1阴性46例，TAM 特异度为94.0％，Cyfra21-1特异度为92.0％，差异无统计学意义（χ2＝0.154，P ＝0.695）。接受化疗患者，有效25例，进展11例，TAM 符合率为77.8％，Cyfra21-1符合率为75.0％，差异无统计学意义（χ2＝0.077，P ＝0.781）。结论TAM 和 Cyfra21-1为食管癌诊断和判定疗效的有用指标，并且 TAM 优于 Cyfra21-1。
多发性硬化症(MS)作为一种中枢神经系统的炎性脱髓鞘疾病,给年轻人群带来了严重危害,已成为非创伤性残疾的首要原因。目前,学界普遍认为其致病机制是多因素共同作用的结果。本文深入探讨了可能触发MS的几种关键致病因素,主要涵盖遗传因素、病毒因素以及自身免疫因素等方面。此外,还对MS的疾病修饰治疗、对症治疗和间充质干细胞治疗方案进行了全面综述,详细分析了各种治疗方案的优缺点以及临床应用前景。通过对这些内容的研究,旨在为进一步理解MS的发病机制以及优化治疗策略提供有益的参考和依据。Multiple sclerosis (MS), as an inflammatory demyelinating disease of the central nervous system, has brought serious harm to young people and has become the leading cause of non-traumatic disability. At present, it is generally believed that the pathogenic mechanism is the result of the combined action of multiple factors. This article provides an in-depth discussion of several key pathogenic factors that may trigger MS, mainly covering genetic factors, viral factors, and autoimmune factors. In addition, the disease-modifying therapy, symptomatic treatment and mesenchymal stem cell treatment regimens of MS are comprehensively reviewed, and the advantages and disadvantages of each treatment regimen and the clinical application prospects are analyzed in detail. Through the study of these contents, it aims to provide a useful reference and basis for further understanding the pathogenesis of MS and optimizing treatment strategies.
